DR. MACKENZIE KELLY MD NPI 1942761580

NPI Information

  • NPI: 1942761580
  • Provider Name: DR. MACKENZIE KELLY, MD
  • Classification: Orthopaedic Surgery - 207XS0114X
  • Specialization: Adult Reconstructive Orthopaedic Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 590 S WAKARA WAY
    SALT LAKE CITY, UT
    ZIP 84108
  • Phone: (801) 581-2121

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NPI Details

DR. Mackenzie Kelly, MD is an adult reconstructive orthopaedic surgery orthopaedic surgery in Salt Lake City, UT with 7 years of experience. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. DR. Mackenzie Kelly, MD NPI is 1942761580. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2019

The provider's business location address is:

590 S WAKARA WAY
SALT LAKE CITY, UT
ZIP 84108-200
Phone: (801) 581-2121

The NPI 1942761580 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/27/2019 and was last updated on 7/25/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery14210189-1205UTAHYes
3207X00000XOrthopaedic SurgeryPG198843OREGONNo
4208600000XSurgery125.073820ILLINOISNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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